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Five lab members posed casually in a small, cramped laboratory.
Lab staff, seen here on March 7, before the hospital’s Universal Mask Policy took effect. From left, Melis Anahtar, MD, PhD, fellow; Sarah Turbett, MD, assistant director of the lab; Jacob Lemieux, MD, PhD, research fellow; Bennett Shaw, clinical research assistant, and Damien Slater, PhD, manager of the neighboring Harris-LaRocque Lab in Infectious Diseases.

In early March, the need for COVID-19 testing was mounting quickly. There were no commercial tests yet, and laboratories were unable to get the materials to perform the Centers for Disease Control and Prevention’s (CDC) test.  

As the need became an emergency, on March 6, a small group of Massachusetts General Hospital researchers began working round-the-clock to create a test. A mere week later, the test was being used on hospital patients, and Mass General would become one of the first academic medical centers to gain approval for a laboratory-developed COVID test. 

The work required not just a sheer number of hours, but also ingenuity, as the team replicated the CDC test as closely as possible while using different materials and instruments. Moreover, the stakes were high, as conducting this work in a clinical laboratory is very different from a commercial laboratory. “It’s like comparing being a home cook to catering a White House state dinner,” says Jacob Lemieux, MD, PhD, research fellow. “Anyone can cook a steak, and if it’s overdone, no problem, but not everyone can precisely prepare food for 1,000 guests and get it to the right table.” 

The task also required some creative staffing, says Sarah Turbett, MD, assistant director of the Microbiology Lab. “This is where having strong collaboration between clinical scientists and basic scientists is really important. We needed people skilled in molecular diagnostics—which we have in our lab—but we couldn’t take them all away from the routine diagnostic work that was still happening. With the help of technicians from research labs, we were able to move quickly.”

At first, the test was labor intensive and only 20 to 30 could be performed per day. Thanks to work by the Mass General Center for Integrated Diagnostics, that number increased to 150 per day. Though this test has since been superseded by commercial tests that can crank out as many as 1,000 results daily, it acted as a crucial bridge, says Eric Rosenberg, MD, director of the Microbiology Lab. “The test gave Mass General a real lead in helping patients and in some circumstances, to enroll patients in clinical trials,” he says. “It was an incredible multidisciplinary effort to make this happen in real time. And we could bring back it on a dime if we needed increased capacity.”

Adds Turbett, “What COVID has shown us is that we must be nimble and flexible. Fortunately, we had the technology and expertise to meet that challenge.”